MOBILE HOME AFFIDAVIT

I understand that Citrus County requires that all mobile/manufactured homes comply with all requirements of the Citrus County Land Development Code and the Citrus County Building and Mobile Home Ordinance, as well as the applicable National Safety code.

In applying for this permit to place a mobile/manufactured home, I hereby affirm that the unit I intend to install was constructed in accordance with the applicable safety code, and that I will be required to produce evidence of that fact before a Certificate of Occupancy is issued. A Department of Motor Vehicles sticker will serve as evidence of compliance. I further affirm that the mobile/manufactured home I intend to install has a minimum living area of 600 square feet and a width of 12 feet or greater.

Signed: ___________________________________ Date: ______________________

(APPLICANT)

I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State of Florida, County of Citrus to take acknowledgements, personally appeared __________________________________ who is personally known to me, or who has produced _______________________________ as identification, and who did/did not take an oath.

WITNESS my hand and official seal this _____________ day of ___________________________, ___________.

_____________________________________

NOTARY PUBLIC